Current Status and Mechanisms of Antibiotic Resistance in Microorganisms

Antibiotic resistance has emerged as one of the most critical challenges to global public health, undermining the effectiveness of existing antimicrobial therapies and threatening the management of infectious diseases. Resistance through diverse genetic and molecular mechanisms enables microorganisms to survive sustained antibiotic effect and persist across clinical, community, and environmental settings. This review provides a comprehensive overview of current status and biological mechanisms of antibiotic resistance in microorganisms. We examine the evolutionary origins of resistance, the genetic architecture underlying resistance acquisition and dissemination, and core molecular processes that reduce antibiotic efficacy. Specific attention is given to resistance expression in host environments, including roles of immune system, microbial interactions, phenotypic heterogeneity, and persister cells in treatment failure. The review explores global landscape of antibiotic resistance, including priority pathogens, regional variations, and influence of healthcare systems. Furthermore, advances in resistance detection methods are discussed. These include phenotypic, molecular, and genomic approaches, along with challenges associated with their clinical interpretation. Finally, current strategies to control antibiotic resistance and future directions for research, surveillance, and policy development are highlighted. By integrating evolutionary, molecular, and clinical perspectives, this review identifies key knowledge gaps and emphasizes need for coordinated, biologically informed approaches to mitigate antibiotic resistance and preserve antimicrobial efficacy.